Inspection on 12/11/08 for Randall House

This inspection was carried out on 12th November 2008.

CSCI found this care home to be providing an Good service.

The inspector found no outstanding requirements from the previous inspection report, but made 2 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

Randall House 23/01/08

Randall House 11/01/07

Randall House 23/11/05

Randall House 21/06/05

Randall House 18/01/05

Randall House 19/07/04

Randall House 09/02/04

Extracts from inspection reports are licensed from CQC, this page was updated on 06/02/2009.

Inspecting for better lives Key inspection report Care homes for adults (18-65 years) Name: Address: Randall House 75 Randall Avenue Neasden London NW2 7SS     The quality rating for this care home is:   two star good service A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full assessment of the service. We call this a ‘key’ inspection. Lead inspector: Julie Schofield     Date: 1 2 1 1 2 0 0 8 This is a report of an inspection where we looked at how well this care home is meeting the needs of people who use it. There is a summary of what we think this service does well, what they have improved on and, where it applies, what they need to do better. We use the national minimum standards to describe the outcomes that people should experience. National minimum standards are written by the Department of Health for each type of care service. After the summary there is more detail about our findings. The following table explains what you will see under each outcome area. Outcome area (for example Choice of home) These are the outcomes that people staying in care homes should experience. the things that people have said are important to them: They reflect This box tells you the outcomes that we will always inspect against when we do a key inspection. This box tells you any additional outcomes that we may inspect against when we do a key inspection. This is what people staying in this care home experience: Judgement: This box tells you our opinion of what we have looked at in this outcome area. We will say whether it is excellent, good, adequate or poor. Evidence: This box describes the information we used to come to our judgement. Copies of the National Minimum Standards – Care Homes for Adults (18-65 years) can be found at www.dh.gov.uk or bought from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop The Commission for Social Care Inspection aims to: · · · · Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Our duty to regulate social care services is set out in the Care Standards Act 2000. Care Homes for Adults (18-65 years) Page 2 of 29 Reader Information Document Purpose Author Audience Further copies from Copyright Inspection report CSCI General public 0870 240 7535 (telephone order line) Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. www.csci.org.uk Internet address Care Homes for Adults (18-65 years) Page 3 of 29 Information about the care home Name of care home: Address: Randall House 75 Randall Avenue Neasden London NW2 7SS 02084520336 02084528544 rc.homes@btinternet.com Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Mrs Lucille Rabor care home 5 Conditions of registration: Category(ies) : Number of places (if applicable): Under 65 mental disorder, excluding learning disability or dementia Additional conditions: The maximum number of service users who can be accommodated is: 5 The registered person may provide the following category of service only: Care Home only - Code PC to service users of the following gender: Either whose primary care needs on admission to the home are within the following categories: Mental Disorder, excluding Learning Disability or Dementia - Code MD Date of last inspection Brief description of the care home Randall House is situated within walking distance of the shops at Neasden. Randall Avenue is close to a bus route and there is access to/from the North Circular Road. The nearest underground station is Neasden. Randall House is a large detached house with a small area at the front of the house and an attractive garden at the rear of the property. The house has a driveway providing on site parking. There is also parking space available on the street outside the house. The home is registered to accommodate 5 adults with mental health needs and at the time of the inspection there was 1 vacancy. There are bedrooms on both the ground and first floor with bathing and toilet facilities on both floors. One of the first floor bedrooms has an en suite facility. Communal space consists of a lounge and of a dining area within a large Care Homes for Adults (18-65 years) Page 4 of 29 Over 65 0 5 Brief description of the care home open plan kitchen/diner. There is an office on the ground floor and a small laundry room. The manager is also the manager of another of the Randall care homes and is the proprietor of 3 care homes and a nursing agency. Please contact the home for information about its services, including a statement of purpose and service users guide and level of fees. Care Homes for Adults (18-65 years) Page 5 of 29 Summary This is an overview of what we found during the inspection. The quality rating for this care home is: Our judgement for each outcome: two star good service Choice of home Individual needs and choices Lifestyle Personal and healthcare support Concerns, complaints and protection Environment Staffing Conduct and management of the home peterchart Poor Adequate Good Excellent How we did our inspection: The inspection took place on a Wednesday in November. It started at 9.30 am and finished at 4.45 pm. During the inspection we spoke with the manager of the home, another manager from the company and members of staff on duty. We also spoke with 3 of the 4 residents living in the home. A tour of the premises took place and records were examined. Compliance with the statutory requirements identified during the previous inspection in January 2008 was checked. We have used the information contained in the Annual Quality Assurance Assessment (AQAA) to inform the inspection. We have received completed survey forms from 2 members of staff and from each of the residents. We would like to thank everyone for their assistance and for their contribution to the inspection. Care Homes for Adults (18-65 years) Page 6 of 29 Care Homes for Adults (18-65 years) Page 7 of 29 What the care home does well: What has improved since the last inspection? What they could do better: If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 4. The report of this inspection is available from our website www.csci.org.uk. You can get printed copies from enquiries@csci.gsi.gov.uk or by telephoning our order line –0870 240 7535. Care Homes for Adults (18-65 years) Page 8 of 29 Details of our findings Contents Choice of home (standards 1 - 5) Individual needs and choices (standards 6-10) Lifestyle (standards 11 - 17) Personal and healthcare support (standards 18 - 21) Concerns, complaints and protection (standards 22 - 23) Environment (standards 24 - 30) Staffing (standards 31 - 36) Conduct and management of the home (standards 37 - 43) Outstanding statutory requirements Requirements and recommendations from this inspection Care Homes for Adults (18-65 years) Page 9 of 29 Choice of home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People are confident that the care home can support them. This is because there is an accurate assessment of their needs that they, or people close to them, have been involved in. This tells the home all about them, what they hope for and want to achieve, and the support they need. People can decide whether the care home can meet their support and accommodation needs. This is because they, and people close to them, can visit the home and get full, clear, accurate and up to date information. If they decide to stay in the home they know about their rights and responsibilities because there is an easy to understand contract or statement of terms and conditions between the person and the care home that includes how much they will pay and what the home provides for the money. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive assessment of the needs of the resident, prior to admission to the home, enables the home to determine whether a service tailored to the residents individual needs can be provided. A programme of visits to the home gives the prospective resident an opportunity to sample life in the home and to decide whether the service provided is suitable. Evidence: Since the last key inspection the category of residents that the home supports has changed from residents with learning disabilities to residents with mental health needs. At the time of the inspection 4 new residents had been admitted to Randall House, although 1 resident had transferred from one of the companys other care homes. We looked at 3 of the residents case files. We saw that prior to each admission a referral had been made and the funding authority had supplied information about the prospective resident. The information included a copy of the FACE Mental Capacity Assessment, a report by an occupational therapist, a report from the psychiatrist, the hospitals risk screening tool and risk management plan, an assessment by the Care Homes for Adults (18-65 years) Page 10 of 29 Evidence: approved social worker and a copy of the discharge summary. A copy of the prospective service users assessment portfolio, which is completed by a manager from the company, was also on file. The pre admission procedure includes the opportunity for the prospective resident to visit the home. A record of the content of these visits is kept in the case file. The programme of visits includes viewing the premises, meeting members of staff, meeting residents, having a meal with everyone and staying over night in the home. Comments and observations by members of staff, residents and the prospective resident were noted. When 1 prospective resident stayed overnight the records stated that the prospective resident liked the house and was happy to move there, that they slept well and that they liked their room. Comments made by another prospective resident were that they liked the home because it is quiet and that they liked the back garden. Three of the 4 residents that completed a survey form ticked that they had been asked if they had wanted to move to this home. One resident that ticked yes added that they had come to view the home with their family. Another resident that ticked yes added that they liked what they saw when they came to the home. When commenting about their decision, whether it was the right place for them, a resident added that the staff were nice and good people and another resident confirmed that they had slept overnight in the home. Care Homes for Adults (18-65 years) Page 11 of 29 Individual needs and choices These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People’s needs and goals are met. The home has a plan of care that the person, or someone close to them, has been involved in making. People are able to make decisions about their life, including their finances, with support if they need it. This is because the staff promote their rights and choices. People are supported to take risks to enable them to stay independent. This is because the staff have appropriate information on which to base decisions. People are asked about, and are involved in, all aspects of life in the home. This is because the manager and staff offer them opportunities to participate in the day to day running of the home and enable them to influence key decisions. People are confident that the home handles information about them appropriately. This is because the home has clear policies and procedures that staff follow. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A comprehensive care plan assures residents that their personal, health and social care needs are identified and addressed. The residents right to exercise choice in their daily lives is promoted and respected. Members of staff support residents to take responsible risks so that residents can enjoy an independent lifestyle. Evidence: The case files of each of the 4 residents living in the home were examined. Each contained a care plan that was based on an assessment of needs for daily living. Where necessary care plans include procedures for residents that may be aggressive. There was evidence that the care plan had been developed with the involvement of the resident. A carer told us that she checked the care plans on a regular basis to see if there were any changes. When discussing equalities and diversity she said that the care plan recorded the religious and cultural needs of the resident. We saw that each element of the care plan is evaluated on a regular basis and that the last evaluations were dated October 2008. Residents files contained evidence of formal reviews taking Care Homes for Adults (18-65 years) Page 12 of 29 Evidence: place. The care home has prepared home review reports prior to CPA meetings taking place. The home has a key worker system in place. We spoke with residents about the opportunities for exercising choice in the home. One of the residents said that residents are asked for their opinions during residents meetings. While we were present in the home during the inspection we saw residents making choices. Residents were choosing what time to get up in the morning, what to eat, what to wear, whether to go out and what to do while they were in the house. The resident that transferred to Randall House told me that he had chosen which room he wanted to occupy. We saw that some residents had a form in the case file known as the Savings Book. This recorded money that is held in the home on behalf of a resident. These forms were up to date and included details of credits and debits. Items of expenditure were recorded and after each transaction the balance was adjusted. Where money was requested and given to the resident the resident signed to acknowledge its receipt. Where necessary members of staff will help residents if the resident is having problems claiming benefits. Case files contained risk assessments. A risk assessment was provided prior to the residents admission to the home and the managers have developed a risk assessment for the resident after admission. The risk assessments developed by the care home are reviewed on a monthly basis and these were up to date. There was a general risk assessment on each file and risk assessments tailored to the individual needs of the resident. These included risk assessments for the management of keys, falling down the stairs, being vulnerable to abuse and for aggressive and hostile behaviour. The home has a missing persons procedure and each case file contains details of the resident that would be required in these circumstances. Care Homes for Adults (18-65 years) Page 13 of 29 Lifestyle These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: Each person is treated as an individual and the care home is responsive to his or her race, culture, religion, age, disability, gender and sexual orientation. They can take part in activities that are appropriate to their age and culture and are part of their local community. The care home supports people to follow personal interests and activities. People are able to keep in touch with family, friends and representatives and the home supports them to have appropriate personal, family and sexual relationships. People are as independent as they can be, lead their chosen lifestyle and have the opportunity to make the most of their abilities. Their dignity and rights are respected in their daily life. People have healthy, well-presented meals and snacks, at a time and place to suit them. People have opportunities to develop their social, emotional, communication and independent living skills. This is because the staff support their personal development. People choose and participate in suitable leisure activities. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Attending day centres and using community resources gives residents the opportunity to enjoy an interesting and stimulating lifestyle. Residents are encouraged to maintain contact with their families and friends so that their need for fulfilling relationships is met. The residents right to privacy and independence is respected and promoted by staff. Menus respect the religious, cultural and dietary needs of residents. Evidence: Each resident has a weekly activity programme and this can include attendance at a day centre, college, drop in centre or taking part in an activity, either inside or outside of the home, according to the interest of the resident. If necessary a resident may receive support when they take part in activities outside the home. When residents go into the community they may walk or use public transport with a freedom pass or use a taxi. Residents use resources in the community including shops, sports centres, Care Homes for Adults (18-65 years) Page 14 of 29 Evidence: restaurants, the library and parks. The company employs an occupational therapist that supports residents in each of the care homes. She has allocated time in Randall House where she works with residents and encourages them to take part in activities including art and cookery. Outings are arranged to include residents from each of the companys care homes, if they wish. There is a regular walking group that residents are encouraged to attend so that they engage in some form of exercise. Residents told us that they have enjoyed visits to the cinema. Residents have contact with their families and either receive visits in the care home or go to visit their relatives, sometimes staying with relatives overnight or at weekends. Residents can entertain their visitors either in the lounge or in their own rooms. They told us that their visitors are made welcome by the members of staff on duty. Residents are encouraged to do what they can for themselves. The residents are expected to do their laundry, ironing, help with cooking, do their personal shopping or help with household chores. Residents can choose when they wish to spend time in their rooms, alone, and this is respected. If a member of staff wants to talk with a resident they knock on the bedroom door and wait until the resident calls out to invite them into the room. When asked on the residents survey form if they made decisions about what they did each day, 3 of the residents ticked sometimes and 1 resident ticked always. Two residents ticked yes they could do what they wanted to do during the day, in the evening and at the weekend. One resident mostly agreed with this but ticked no for during the day. The fourth resident ticked yes and no for during the day and at the weekend. Menus were available to examine. Menus follow a 5 week rotation and meals for the companys 4 care homes are cooked in one home, on a rota basis. The menu is varied and wholesome and caters for the religious and cultural needs of the residents and for their preferences. One resident is Muslim and they are not offered pork. Two residents are African Caribbean and menus include fried fish, spicy chicken and cow foot with beans. One of the residents is diabetic and 2 of the residents are trying to reduce their weight. One resident prefers not to eat red meat. A record of what the individual resident eats on a daily basis is kept. Residents were satisfied with the meals served in the home and confirmed that if required, an alternative was offered. Care Homes for Adults (18-65 years) Page 15 of 29 Personal and healthcare support These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People receive personal support from staff in the way they prefer and want. Their physical and emotional health needs are met because the home has procedures in place that staff follow. If people take medicine, they manage it themselves if they can. If they cannot manage their medicine, the care home supports them with it in a safe way. If people are approaching the end of their life, the care home will respect their choices and help them to feel comfortable and secure. They, and people close to them, are reassured that their death will be handled with sensitivity, dignity and respect, and take account of their spiritual and cultural wishes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents receive prompting with personal care in a manner, which respects their dignity and privacy. Residents health care needs are met through access to health care services in the community. Residents general health and well being is promoted by staff that assist the resident to take prescribed medication in accordance with the instructions of the residents GP. Evidence: A discussion took place regarding the provision of personal care. Two residents are self caring and 2 residents require some prompting and practical assistance e.g. running a bath for a resident. The composition of the staff team includes people from the same cultural background as residents and residents benefit from members of staff with an understanding of their skin care and hair care needs. Residents choose what clothing to wear although a member of staff may advise a resident regarding dressing appropriately for the weather conditions. Residents times for getting up and going to bed and for meals times etc are flexible but they are encouraged to keep regular hours so that they are able to attend meetings, appointments and drop in centres etc on time. There is evidence on file that when necessary, assistance and support is Care Homes for Adults (18-65 years) Page 16 of 29 Evidence: requested from specialists. Examples of this are regular contact with a psychiatrist or a referral to the dietician. Residents files contained evidence of access to health care facilities in the community. Case files contained an appointment tracking sheet and this made it easy to check the date of the last appointment with a particular health care professional. There were regular appointments with the optician, the dentist and the chiropodist. A record was also kept of appointments with the GP. A letter on a case file confirmed that support i.e. an escort is provided when residents have out patient appointments at the hospital clinics. A medication policy is in place in the home. None of the residents self medicate. The storage of medication was safe and secure. Medication is administered to residents from weekly dosette boxes that have filled by the pharmacist. When we examined these we noted that tablets had been removed from the compartments in accordance with the day of the week and the time of day that the inspection took place. We looked at the administration of medication records and saw that they were up to date. Staff receive medication training and when we looked at staff files they contained a certificate of attendance for an external training course that had taken place in 2008. Care Homes for Adults (18-65 years) Page 17 of 29 Concerns, complaints and protection These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: If people have concerns with their care, they or people close to them, know how to complain. Their concern is looked into and action taken to put things right. The care home safeguards people from abuse, neglect and self-harm and takes action to follow up any allegations. There are no additional outcomes. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. A complaints policy and procedure is in place to protect the rights of residents. An adult protection policy and protection of vulnerable adults training for staff contribute towards the safety of residents. Evidence: A complaints policy and procedure is in place in the home. It includes information regarding the stages and the timescales involved in the process. It also informs the complainant of their right to contact other agencies and includes contact details for the local office of the Commission for Social Care Inspection. We were told that during the pre admission period the prospective resident is made aware of the policy and when they are admitted to the home a residents file is placed in their room and this includes a copy. The manager said that no complaints have been recorded since the last inspection. When we spoke with residents they told us that they could talk to the managers if they had a problem or a complaint. A protection of vulnerable adults procedure is in place. The manager said that no allegations or incidents have been recorded since the last inspection. When we spoke with residents they told us that they could talk to a member of staff, including the managers, if they had a concern or if something was worrying them. There was evidence on the staff files that we looked at that protection of vulnerable adults training has been undertaken in 2008. When we spoke with members of staff they Care Homes for Adults (18-65 years) Page 18 of 29 Evidence: were able to clearly explain their responsibilities in the event of an allegation or incident of abuse. The manager said that the home does not practice restraint and that members of staff receive training in respect of challenging behaviour. Care Homes for Adults (18-65 years) Page 19 of 29 Environment These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People stay in a safe and well-maintained home that is homely, clean, comfortable, pleasant and hygienic. People stay in a home that has enough space and facilities for them to lead the life they choose and to meet their needs. The home makes sure they have the right specialist equipment that encourages and promotes their independence. Their room feels like their own, it is comfortable and they feel safe when they use it. People have enough privacy when using toilets and bathrooms. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. Residents live in a home, which is comfortably furnished and provides a pleasing environment for residents to relax in and to enjoy. Residents live in a home where standards of cleanliness are good. Evidence: A site inspection took place and we noted that the home was decorated and furnished in a homely manner and that the general upkeep of the property is good. Since the last inspection the category of client has changed and while this took place and the home was empty a programme of redecoration and refurbishment was carried out. This included new carpet or new flooring being provided throughout and the installation of a more efficient boiler. In the kitchen the doors of the kitchen cabinets were replaced. Residents were satisfied with their rooms and thought that they were of a good size. We noted that in the kitchen and dining area there were numerous notices for members of staff that detracted from a homely environment for residents. We discussed the home in respect of accessibility, if a resident had mobility problems. There are steps up to the front door. However, there is level access to the home using the door to the kitchen and diner, after going around the side of the house. On the ground floor there is a bedroom and bathing and toilet facilities. Residents have the Care Homes for Adults (18-65 years) Page 20 of 29 Evidence: use of a beautiful, large garden with patio and lawn areas. All areas seen were clean and tidy and free from any offensive odours. When asked on the residents survey form, 3 of the 4 residents agreed that the home is always fresh and clean while 1 resident ticked usually. There is a laundry room on the ground floor. Using this room does not involve carrying laundry through any area where food is stored, prepared or eaten. Since the last inspection a new tumble drier has been installed. A member of staff on duty in the home confirmed that she had received infection control training and there was evidence on staff files that other members of staff had attended this recent training. Care Homes for Adults (18-65 years) Page 21 of 29 Staffing These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have safe and appropriate support as there are enough competent, qualified staff on duty at all times. They have confidence in the staff at the home because checks have been done to make sure that they are suitable. People’s needs are met and they are supported because staff get the right training, supervision and support they need from their managers. People are supported by an effective staff team who understand and do what is expected of them. This is what people staying in this care home experience: Judgement: People using this service experience adequate quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. NVQ training enhances the general skills and knowledge of carers and the home has met the target of at least 50 per cent of carers achieving an NVQ level 2 or 3 qualification. Although there were sufficient members of staff on duty on the day of the inspection to meet the needs of the residents, the rota failed to demonstrate that there are sufficient members of staff on duty at all times. Recruitment practices, which include carrying out checks and taking up references, help to protect the welfare and safety of residents. Taking up references from persons independent of the applicant would assure residents of the validity and the reliability of references. The training programme enables members of staff to broaden and to develop their knowledge and skills and encourages good working practices. Evidence: We discussed the programme of NVQ training for members of staff and the manager told us that of the 7 names of carers listed on the rota, 5 of the carers have attained an NVQ level 2 or 3 qualification. Another member of staff has almost completed their NVQ level 2 training and the newest member of staff is about to start their NVQ training. The home has met the recommended target of 50 per cent of carers achieving an NVQ qualification. When we spoke with residents they told us that that the staff were helpful and supportive and 1 resident said that they sorted things out. Care Homes for Adults (18-65 years) Page 22 of 29 Evidence: Although the home is registered to accommodate up to 5 residents, at the time of the inspection there was 1 vacancy. During the inspection there were 3 members of staff on duty in the morning, including a manager, and 2 members of staff on duty during the afternoon and evening. We were told that there are always at least 2 people on duty per shift and that at night a member of staff sleeps in on the premises but is on call in case a resident needs assistance. We looked at a copy of the rota and noted that on several occasions there was only 1 name recorded per shift. The 2 members of staff that completed a survey form agreed that there were always enough staff on duty to meet the individual needs of all of the people who use the service. The hours worked on site by the manager are recorded on the rota and reflect the fact that the manager is also the registered manager for another care home in the same road. There is also information on the rota about the on call system for contacting a manager when advice or support is needed. When asked on the residents survey form whether staff treated them well, 2 of the residents ticked always and 2 of the residents ticked usually. The personnel files for 2 members of staff were examined. Each file contained an application form and this included a statement about the medical history of the applicant and whether they had any cautions or convictions. Staff files also contained a contract, 2 references, an enhanced CRB disclosure and proof of identity in the form of passport details. The right to live and to reside in the UK had been established. We noted that on 1 staff file a reference had been given by a relative of the applicant. The two staff files examined contained training profiles, including attendance certificates. There was evidence that staff received training in safe working practice topics i.e. manual handling, infection control, first aid, food hygiene and fire safety. There was also training in medication, mental health and in protection of vulnerable adults procedures. The home uses a package of induction training for new members of staff and a record of this was present on the staff files. We have been previously told that the company is planning to include any amendments necessary so that it is similar to the Sector Skills Councils Common Induction Standards. When asked on the staff survey form whether the induction covered everything they needed to know to do the job when they started, 1 member of staff ticked very well and the other member of staff ticked mostly. When asked whether they were given training which is relevant to their role, helps them to understand and meet the individual needs of the residents and that keeps them up to date with new ways of working they both ticked yes. Care Homes for Adults (18-65 years) Page 23 of 29 Conduct and management of the home These are the outcomes that people staying in care homes should experience. They reflect the things that people have said are important to them: People have confidence in the care home because it is run and managed appropriately. People’s opinions are central to how the home develops and reviews their practice, as the home has appropriate ways of making sure they continue to get things right. The environment is safe for people and staff because health and safety practices are carried out. People get the right support from the care home because the manager runs it appropriately, with an open approach that makes them feel valued and respected. They are safeguarded because the home follows clear financial and accounting procedures, keeps records appropriately and makes sure staff understand the way things should be done. This is what people staying in this care home experience: Judgement: People using this service experience good quality outcomes in this area. We have made this judgement using a range of evidence, including a visit to this service. The registered manager has developed her knowledge through further training and this contributes towards understanding the needs of residents and staff. Systems are in place to help monitor the quality of the service provided to residents and contribute towards the development of the service. Training in safe working practice topics enables members of staff to safeguard the health, safety and welfare of the residents. Regular servicing and checking of equipment used in the home ensures that items are in working order and safe to use. Evidence: The registered manager has completed her Registered Managers Award and has shown evidence of this on a previous inspection. She is also a qualified RGN. She has managed the home since its initial registration. Within the companys services she is the registered manager for 2 of the care homes in Randall Ave and the manager of the nurses agency. She is the proprietor for 3 of the care homes and for the nurses agency. Since the last inspection she has attended training courses in safe working practice topics, mental health and protection of vulnerable adults procedures. Both Care Homes for Adults (18-65 years) Page 24 of 29 Evidence: members of staff that completed a survey form agreed that their manager met with them to give them support and to discuss how they were working on a regular basis. We discussed quality assurance systems in place in each of the care homes within the company as the client category for Randall House has changed since the last key inspection and all of the residents have been admitted to the home since August 2008. We were told that residents meetings are held on a regular basis and that a record is kept of these. When talking with residents a resident confirmed this and said that he was asked for his views and opinions during the meeting. In addition to this, other methods of obtaining feedback from the residents about the quality of the service include meetings between the resident and their key worker or the manager, on a 1 to 1 basis, during review meetings, on an informal basis with an open door policy to the office and by the use of survey forms. We noted that members of staff have the opportunity to give feedback about the quality of service provision during staff meetings, during supervision, on an informal basis and by the use of survey forms. The home encourages relatives to make comments during their visits to the home and we saw that positive feedback had been recorded. One relative said that they had been made a nice cup of tea and that they were impressed with the tasks that the resident is managing independently. Another relative said that they were pleased with the support given by the key worker who has built a good relationship with the resident. We were shown certificates for the servicing or checking of the systems and the equipment used in the home. They included valid documents for the fire extinguishers, fire alarm system, Landlords Gas Safety Record, the testing of the portable electrical appliances and the electrical installation. Records demonstrate that fire drills are held on a regular basis, including an evacuation of the home, and that the fire and smoke alarms are tested on a weekly basis. A member of staff on duty in the home confirmed that she had received training in safe working practice topics in 2008. This covered manual handling, fire safety awareness, infection control, first aid and food hygiene. Staff files contained copies of attendance certificates for these courses. Care Homes for Adults (18-65 years) Page 25 of 29 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards No. Standard Regulation Requirement Timescale for action Care Homes for Adults (18-65 years) Page 26 of 29 Requirements and recommendations from this inspection: Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours. No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set. No. Standard Regulation Requirement Timescale for action 1 33 18 When drawing up the rota for the home the manager must check that the names of 2 members of staff are entered for each of the day shifts. This will enable the home to make sure that staffing levels are sufficient to meet the needs of the residents and to demonstrate this by keeping an accurate record. 01/01/2009 2 34 19 When sending reference requests for a prospective member of staff the manager must check that the referee is not related to the applicant. This will ensure that references are obtained from an independent source. 01/01/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service. Care Homes for Adults (18-65 years) Page 27 of 29 No. Refer to Standard Good Practice Recommendations 1 24 That a review takes place of where notices for the attention of members of staff are displayed so that these do not intrude on residents space or on the enjoyment of their environment. Care Homes for Adults (18-65 years) Page 28 of 29 Helpline: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2008) Commission for Social Care Inspection (CSCI). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CSCI copyright, with the title and date of publication of the document specified. Care Homes for Adults (18-65 years) Page 29 of 29 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!